Moneyatrics: Getting more for your healthcare dollar

Ready or not, Rhode Islanders: You’re about to take more responsibility for your healthcare decisions. Not just because I’m urging you to, but because three forces are conspiring to make it that way.

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By
Dr. Andy Robin
Posted Jul. 7, 2013 @ 12:01 am

Ready or not, Rhode Islanders: You’re about to take more responsibility for your healthcare decisions. Not just because I’m urging you to, but because three forces are conspiring to make it that way.

Force number one: Public Law 111 – 148, The Patient Protection and Affordable Care Act. This federal law will goad more of you into buying your own health insurance. Which means you’ll become better acquainted with things like premiums, deductibles, copays, and coinsurance. Which means you’ll be more eager to find ways of spending less on them.

Force two: Transparency. The information genie has left the medicine bottle, with many websites offering reliable information about procedures, treatments, medications, and costs. These websites are inching their way closer to healthcare versions of Travelocity.

Force three: An era of belt-tightening. A wealthy sliver of the population can keep up with persistently rising healthcare costs. The rest of us can’t.

We’re forced to be more selective about things like exams, scans and medications in order to pay for things like housing, heat, and food.

Worried? That’s natural. It’s a big responsibility taking more control of your healthcare, with physical, psychological and financial consequences.

Healthcare is extremely complicated, even before stirring personal finance into the mix. And decisions are harder when we’re sick or preoccupied by loved ones’ health issues. At such times, it’s easy to assume that clinicians’ decisions are in our best interests. But that needn’t be the case.

I know from personal experience.

Years before I became a medical student, I found myself at the hospital with my pregnant, laboring wife, Anna. Anna wanted an epidural for her pain and I assumed she would receive one as soon as was medically appropriate. Hours later, when the anesthesiologist finally arrived, our son, Peter, was moments from being delivered. We were told it was too late to for an epidural. I was stunned and angry and felt like a fool.

My anger re-emerged when a bill for the nonexistent epidural arrived two weeks later. I called the anesthesiologists’ office, working to keep my cool.

After some resistance, they finally dropped the charge. I then called our insurance company so they could recoup what they had paid. They told me they wouldn’t bother. So much for accountability.

Ironically, we had been lucky. I had spotted the error. Every day, patients are oblivious to erroneous healthcare charges, overcharges, charges for services they would have declined if asked, and charges for services they would have swapped for cheaper alternatives.

Today, a month after graduating from Brown Medical School, I’m more convinced than ever that patients should be less complacent about their care and that clinicians should be explicit about costs and alternatives. In fact, as other students head off to specialties like pediatrics, psychiatry and surgery, my classmate Dr. John Luo and I are taking time to forge a much needed expertise: helping people manage their healthcare costs.

Or, as we like to tell our relatives, Moneyatrics.

John and I were fortunate to be able to spend much of final year of school studying medical decision making and the structure of health insurance, including Medicare. Inspired by the real life experiences of three 64-year-old physicians confused by their Medicare options, we built the website MedicareCheckup.com. And I’ve launched this column, which will offer practical advice for healthcare consumers.

In upcoming articles, we’ll tackle tricky questions: When should you go to the hospital? When should you use a healthcare advocate? Can you negotiate your hospital bill? What insurance is appropriate for you? What does insurance lingo mean? (Like that funny phrase “out-of-pocket” cost. Doesn’t every cost come out of our pockets?)

There is no reason to pay more than you have to for anything, including healthcare. In fact, paying more can be hazardous to your health. So please submit your money-related healthcare questions for future columns and join me next time for more adventures in Moneyatrics.

Dr. Andy Robin is a graduate of Harvard College and Brown Medical School and an award-winning TV writer for such shows as “Seinfeld” and “Saturday Night Live.” He is co-creator of MedicareCheckup.com, which helps Medicare-eligible people find appropriate Medicare plans.

Submit your questions for Dr. Andy Robin to

Features@providencejournal.com, and be sure to include “Moneyatrics” in the subject line. Or you can mail them to Moneyatrics, Features Department, 75 Fountain St, Providence RI 02902.